Healthcare Provider Details

I. General information

NPI: 1891791901
Provider Name (Legal Business Name): SIOUX VALLEY MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E PINE ST
MARCUS IA
51035-7196
US

IV. Provider business mailing address

300 SIOUX VALLEY DR
CHEROKEE IA
51012-1205
US

V. Phone/Fax

Practice location:
  • Phone: 712-376-4600
  • Fax: 712-376-4709
Mailing address:
  • Phone: 712-225-6265
  • Fax: 712-225-6800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOAN M BIERMAN
Title or Position: CFO
Credential:
Phone: 712-225-1505